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Organization
DYNAMIC PHYSICAL THERAPY ASSOC.PLLC
Active
Organization
DYNAMIC PHYSICAL THERAPY ASSOC.PLLC
Active
Other names
dba Dynamic Sports Physical Therapy & Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA ELLIS (CREDENTIALING/BILLER)
(631) 470-9515
Entity
Organization
Contact information
Practice address
164 E MAIN ST, HUNTINGTON, NY 11743-2955
(631) 470-9515
(631) 470-9513
Mailing address
164 E MAIN ST, HUNTINGTON, NY 11743-2955
(631) 470-9515
(631) 470-9513
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/27/2008
Last updated
08/12/2008
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